Anxiety affects approximately 10% of children between the ages 3-17 in the United States. Since this is an estimate for children who are formally diagnosed with anxiety, this does not account for thousands of children who experience undiagnosed symptoms of anxiety or anxious behavior. Let’s take a look at Jayden’s story:
Jayden is an 8-year-old boy who attends a typical public elementary school. It’s his first year to take state exams for both English and mathematics which take up the entirety of the school day. Although Jayden is very intelligent, he experiences symptoms of anxiety before and during testing. In fact, his symptoms are so distracting that it affects his academic performance and his desire to attend school. Sometimes, he calls his mother to go home due to horrible stomach pains and nausea.
Occupational Therapy is effective in helping a child who is experiencing anxiety to improve their overall functioning; this can include at school, home, or in the community. OTs can help these children learn many coping skills to help manage their anxiety, build resilience and self-confidence, and so much more. As always, the specific techniques and strategies used will depend on the child’s specific needs and personal goals.
How can an occupational therapist help a child who is suffering from anxiety?

Anxiety in the pediatric population can produce devastating outcomes, and greatly impacting overall functional performance. According to the American Psychiatric Association (APA), anxiety is usually characterized by:
- Excessive worry
- Difficulty concentrating
- Muscle tension
- Easy to fatigue
- Irritability
- Restlessness
- Poor sleep quality
For children to be diagnosed with generalized anxiety disorder (GAD), they generally have to display symptoms for six months or more. However, many kids commonly experience symptoms of anxiety without a diagnosis.
Occupational therapy can help children with anxiety because it is a holistic approach that examines all factors of a child’s life: personal preferences, the environment, and the child’s activities. Before beginning intervention, an OT may conduct the following to get to know the child first:
- An in-home or outpatient evaluation to assess the child’s needs and daily routine
- Develop rapport with the child to help him or her feel comfortable during sessions
- Discussing the child’s personal goals, what anxiety is keeping them from, and what they would like to succeed in.
- Consulting with primary physicians, psychiatrists, school counselors, and other relevant professionals in the child’s life
- Getting to know the child’s parents and family to better understand the child’s life at home and potential family goals for therapy
Here are just a handful of OT interventions that have proven effective for children with anxiety or anxious behavior:
- Mindfulness, breathing exercises, and relaxation techniques
- Education in coping strategies and learning to identify triggers
- Social skills training to interact with peers and adults
- Play therapy to increase self-awareness, emotional regulation, and verbal expression
- Techniques to boost self-esteem and validation
Though OT can be an excellent tool for children like Jayden who have testing anxiety, kids with additional complications can benefit as well:
Emily is a 9 year old girl who struggles with making friends at school. Although she is quite verbal, she experiences social limitations due to autism spectrum disorder (ASD) and language processing issues. As a result, she has developed anxiety in regards to making conversation with classmates, attending birthday parties, and participating in afterschool sports. For the past few months, Emily has been attending OT sessions once per week to learn and apply age-appropriate social skills to reduce her feelings of anxiousness around others. Her OT has helped her create social stories through play therapy while simultaneously learning deep breathing techniques to help mentally and emotionally prepare her to engage in conversation.
OT can also be helpful for children whose anxiety stems from sensory processing irregularities:
Casper is an 11-year-old boy with generalized anxiety disorder who’s being evaluated by OT for sensory processing disorder. Although Casper is a very friendly, bright kid, he struggles with the idea of going outside due to some specific aversions. He can’t stand getting dirty and refuses to walk in grass, sand, gravel, or any area besides a freshly swept sidewalk. He hates the sound of insects whizzing by his head and he’s terrified of dogs approaching him due to their smell and loud barks. As a result, he avoids the outdoors or experiences severe meltdowns when forced out of the house. His family finds it extremely challenging to take him on summer trips and often resorts to staying home or leaving him with other family members.
For Casper’s situation, an OT with sensory integration training can specifically address his unique triggers for anxiety symptoms and gradually improve behavior to tolerate (and even enjoy!) the outdoors.
Why should someone consider occupation therapy for their child who is experiencing anxiety?

Many children and adults will intuitively turn to psychiatry or mental health counseling if symptoms of anxiety greatly affect daily life. While there is certainly nothing wrong with this approach, parents and families should also be aware that OT has its place in helping individuals successfully manage anxiety:
- OT provides non-pharmacological (no medication) approaches to treating symptoms of anxiety
- OTs assess factors and interactions to reveal triggers that may be missed by other professionals
- Research has shown that OT is very effective in reducing anxiety in children
- OTs focus on developing a child’s skill set so they can independently monitor their own symptoms during real-life situations
- OTs provide support and education for the child, their family, and/or their caregivers to increase chances of carryover
Occupational therapy can be used as a standalone intervention or be applied in conjunction with other treatment approaches depending on the child’s needs and the severity of their anxiety symptoms.
Conclusion
Anxiety or anxious behavior in children is more common than we think, which causes debility and dysfunction that children may not know how to manage on their own. Fortunately, occupational therapy is an effective treatment tool for children and their families in managing and reducing anxiety. It helps facilitate success in academics, home activities, and community participation. Check out The Therapy Place online to see if our services can help your child who is struggling with anxiety (or any child!) develop and succeed. https://www.therapyplacenj.com/
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